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Gepubliceerd in: Neuropraxis 1/2013

01-02-2013 | Artikelen

De amygdala, een schakelstation voor het aan- en uitzetten van pijn: de rol van limbisch corticotropin-releasing factor bij neuropathische pijn

Auteurs: Dr. Tom Rouwette, dr. Pascal Vanelderen, prof. dr. Eric Roubos, prof. dr. Tamás Kozicz, prof.dr. Kris Vissers

Gepubliceerd in: Neuropraxis | Uitgave 1/2013

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Samenvatting

Corticotropin-releasing factor (CRF) is essentieel bij stressadaptatie en veroorzaakt fysiologische stressresponsen via de hypothalamus-hypofyse-bijnier-as (HHB-as), wat leidt tot een verscheidenheid aan gedragsveranderingen en autonome en endocriene effecten om fysiologische en mentale homeostase te waarborgen (Chrousos & Gold, 1992; Smagin & Dunn, 2000; Vale et al., 1981). Dit gebeurt doordat CRF als neurotransmitter en/of neuromodulator op het centrale zenuwstelsel (CZS) werkt, met de limbische bed-nucleus van de stria terminalis (BST) en de centrale amygdala (CeA) (Deyama et al., 2007; Ji & Neugebauer, 2008) als belangrijke inputgebieden. Door chronische pijn wordt het functioneren van de HHB-as vaak ontregeld. Hierdoor kunnen angststoornissen en depressie optreden, ziekten die regelmatig geassocieerd blijken met een verstoorde werking van limbisch CRF (Arborelius et al., 1999; Blackburn-Munro & Blackburn-Munro, 2001). Recent is de sterke link tussen pijnverwerking en CRF beschreven (Lariviere & Melzack, 2000) en bewijs voor de betrokkenheid van limbisch CRF bij nociceptieve gevoeligheid, ofwel de gewaarwording van pijn, tijdens neuropathische pijn neemt toe (Bomholt et al., 2005; Rouwette et al., 2012a; Ulrich-Lai et al., 2006). Dit review geeft een overzicht van uitkomsten uit recent onderzoek naar hersengebieden die betrokken zijn bij het optreden van neuropathische pijn, waarbij de nadruk ligt op de rol hierbij van CRF. De amygdala, een kern in de temporaalkwab die lijkt te kunnen schakelen tussen nociceptie en analgesie, wordt beschouwd als belangrijk hersengebied voor pijnverwerking.
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Metagegevens
Titel
De amygdala, een schakelstation voor het aan- en uitzetten van pijn: de rol van limbisch corticotropin-releasing factor bij neuropathische pijn
Auteurs
Dr. Tom Rouwette
dr. Pascal Vanelderen
prof. dr. Eric Roubos
prof. dr. Tamás Kozicz
prof.dr. Kris Vissers
Publicatiedatum
01-02-2013
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Neuropraxis / Uitgave 1/2013
Print ISSN: 1387-5817
Elektronisch ISSN: 1876-5785
DOI
https://doi.org/10.1007/s12474-013-0002-3

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